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Optimal Kidney Exchange with Immunosuppressants [article]

Haris Aziz, Agnes Cseh, John P. Dickerson, Duncan C. McElfresh
2021 arXiv   pre-print
Motivated by the current reality of kidney exchanges using sophisticated mathematical-programming-based clearing algorithms, we then present a general but scalable approach to optimal clearing with immunosuppression  ...  with originally incompatible kidneys.  ...  All rights reserved. as Kidney Exchange with Immunosuppressants (KEI).  ... 
arXiv:2103.02253v1 fatcat:6gkazrui2zedhddnrwoy5ygfku

Long-term desensitization for ABO-incompatible living related kidney transplantation recipients with high refractory and rebound anti-blood type antibody: case report

Hiroaki Nishimura, Yasutoshi Yamada, Satoshi Hisano, Akihiko Mitsuke, Syuichi Tatarano, Takenari Gotanda, Hiroshi Hayami, Masayuki Nakagawa, Hideki Enokida
2018 BMC Nephrology  
Further studies are required to establish the optimal immunosuppression regimen to control B cell-mediated immunity in ABO-iLKT.  ...  ABO-incompatible living related kidney transplantation (ABO-iLKT) has increased the possibilities for kidney transplantation in patients with end stage renal disease.  ...  pairs from the Netherlands National Living Donor Kidney Exchange Program [25] .  ... 
doi:10.1186/s12882-018-1053-8 fatcat:rw4lxxnhlnhiznl6e6xcjufkzq

International kidney paired donation transplantations to increase kidney transplant of O group and highly sensitized patient: First report from India

Vivek B Kute, Himanshu V Patel, Pankaj R Shah, Pranjal R Modi, Veena R Shah, Sayyed J Rizvi, Bipin C Pal, Priya S Shah, Pavan S Wakhare, Saiprasad G Shinde, Vijay A Ghodela, Umesh T Varyani (+3 others)
2017 World journal of transplantation  
The two donor recipient pairs had negative lymphocyte cross-matching, flow cross-match and donor specific antibody in two way kidney exchange with the intended KPD donor.  ...  Both pairs underwent simultaneous uneventful kidney transplant surgeries and creatinine was 1 mg/dL on tacrolimus based immunosuppression at 11 mo follow up.  ...  The large donor pool will increase the transplant rate in kidney exchange. It allows an optimized donorrecipient match, due to an expansion of the donor and recipient pool.  ... 
doi:10.5500/wjt.v7.i1.64 pmid:28280697 pmcid:PMC5324030 fatcat:a5hgtd6d7ngxhhetudtegbnfra

Endorsement of the Kidney Disease Improving Global Outcomes (KDIGO) guidelines on kidney transplantation: a European Renal Best Practice (ERBP) position statement

U. Heemann, D. Abramowicz, G. Spasovski, R. Vanholder
2011 Nephrology, Dialysis and Transplantation  
Kidney paired donation in live-donor kidney transplantation. N Engl J Med 2010; 363: 1091-1092 60. Zenios SA. Optimal Control of a Paired-Kidney Exchange Program.  ...  Immunosuppression is essential for the success of transplantation for which optimally a combination of drugs is needed.  ... 
doi:10.1093/ndt/gfr169 pmid:21555392 fatcat:ui7i4z4o7zesjcbrvnuxmcnk5e

Primary Cytomegalovirus Infection Causing Guillain-Barré Syndrome in a Living Renal Allograft Recipient

Massini Merzkani, Ezra Israel, Mala Sachdeva
2017 Case Reports in Transplantation  
There have been few reported cases of Guillain-Barré Syndrome associated with active cytomegalovirus (CMV) infection in renal transplant recipients.  ...  Optimal treatment for Guillain-Barré Syndrome in the immunosuppressed kidney transplant recipient is still unknown.  ...  In kidney transplant recipients, GBS has been a rare occurrence and optimal treatment in this population has not yet been defined. On the contrary, CMV in kidney transplantation is not uncommon.  ... 
doi:10.1155/2017/7264793 pmid:29348962 pmcid:PMC5733958 fatcat:6au5qvrt6vc35nv2qmhuixfzem

Pediatric Renal Transplantation in a Highly Sensitised Child—8 Years On

Catherine Quinlan, Atif Awan, Denis Gill, Mary Waldron, Dilly Little, David Hickey, Peter Conlon, Mary Keogan
2011 Case Reports in Transplantation  
We developed a protocol involving sequential therapies with rituximab, IVIg, and plasma exchange.  ...  The graft kidney continues to function well 8 years posttransplant.  ...  Introduction Kidney transplantation remains the optimal treatment for end-stage renal failure (ESRF).  ... 
doi:10.1155/2011/370596 pmid:23198257 pmcid:PMC3505953 fatcat:tcdfeuleizezbn3hhlxapszhlu

Should the allocation of cadaveric kidneys for transplantation be based on HLA matching?

R. A. P. Koene
2002 Nephrology, Dialysis and Transplantation  
Exchange should be limited to kidneys with no HLA mismatches and to kidneys for which a highly sensitized recipient with a negative crossmatch is present on the waiting list.  ...  The results suggest that HLA matching is not a conditio sine qua non for a successful renal transplantation and that, with current immunosuppressive protocols, ischaemia time has become a more decisive  ... 
doi:10.1093/ndt/17.5.717 pmid:11981053 fatcat:uhypmycdrzhk7agrjm66ugrlae

Kidney transplantation among identical twins: therapeutic dilemmas

K. Dziewanowski, R. Drozd, A. Chojnowska, M. Dziewanowska-Rogalska, M. Parczewski
2011 BMJ Case Reports  
The patient was regularly dialysed since 1996 (starting at the age of 14), at fi rst by peritoneal dialysis, then due to the recurrent peritonitis and loss of exchange effi cacy, with haemodialysis.  ...  With unproblematic and optimal transplant function the clinician often tends to be willing to reduce the immune suppresion; however, in practice the fear against the transplant rejection is overwhelming  ... 
doi:10.1136/bcr.01.2011.3752 pmid:22689721 pmcid:PMC3149447 fatcat:e7jvh3zuh5f5lhhwj2ifsulczq

Recent advances in kidney transplantation: a viewpoint from the Descartes advisory board*

Daniel Abramowicz, Rainer Oberbauer, Uwe Heemann, Ondrej Viklicky, Licia Peruzzi, Christophe Mariat, Marta Crespo, Klemens Budde, Gabriel C Oniscu, Bruno Watschinger, Luuk Hilbrands, Umberto Maggiore (+1 others)
2018 Nephrology, Dialysis and Transplantation  
Eurotransplant; kidney exchange strategies; kidney machine perfusion strategies; the changing landscape of anti-human leukocyte antigen (HLA) antibodies; the new immunosuppressive drugs in the pipeline  ...  Here, we have summarized the main knowledge and the main challenges of these seven topics with the aim to provide transplant professionals at large with key bullet points to successfully understand these  ...  Until these novel therapeutic strategies are available, optimization of the current immunosuppressants regimens, tailored to the individual patient and biomarker-driven with optimized drug dosing and better  ... 
doi:10.1093/ndt/gfx365 pmid:29342289 fatcat:7yjw6kjd5zfb5jrlbynkbvbx24

Past and Future Prospects of Orthoptic Liver Transplantation

Thomas E. Starzl
1981 Archives of Surgery  
Optimal therapy with cyclosporin A has required steroid therapy, but the amounts of prednisone used have been a small fraction of those used in the past.  ...  The hopes for liver transplantation have been increased by experience with the new immunosuppresive drug cyclosporin A.  ...  In our center, we have shown that cyclosporin A alone, even in doses of 15 to 20 mg/kg/day, does not consistently prevent rejection, that it should be combined with steroid therapy for optimal use, and  ... 
doi:10.1001/archsurg.1981.01380220086013 pmid:7025801 pmcid:PMC2972743 fatcat:vcvah7wmpza6dcgzdftfze5myy

Fatal Pneumococcus Sepsis after Treatment of Late Antibody-Mediated Kidney Graft Rejection

Gunilla Einecke, Jan Hinrich Bräsen, Nils Hanke, Hermann Haller, Anke Schwarz
2018 Case Reports in Nephrology  
The increased immunosuppression with B cell depletion may have contributed to the overwhelming course of this infection.  ...  Recurrent infections after a splenectomy following traumatic splenic rupture 3 years earlier had led to reduction of immunosuppression.  ...  These options include (1) avoiding apheresis in this splenectomized patient, optimizing maintenance immunosuppression, and preparing patient for dialysis; (2) optimizing maintenance immunosuppression,  ... 
doi:10.1155/2018/1415450 pmid:29682370 pmcid:PMC5851299 fatcat:dvtgx6j4rjhndm5rgr2amyhoiu

Low Dose Rabbit Anti-Thymocyte Globulin as an Induction immunosuppression in High-Risk Renal Transplant Recipients

Ahmed Halawa
2017 Urology & Nephrology Open Access Journal  
There is no consensus for the optimal agent used as induction immunosuppression in kidney transplantation. rATG use is associated with decreased incidence of delayed graft function and acute rejection  ...  It is associated with early acute rejection post-transplantation and leads to decrease patient and graft survival.  ...  Conclusion There is no consensus for the optimal agent used as induction immunosuppression in kidney transplantation. rATG use is associated with decreased incidence of delayed graft function and acute  ... 
doi:10.15406/unoaj.2017.04.00134 fatcat:h2kirxgkhzfyfdjqgtrrsqt6ei

Beyond Survival in Solid Organ Transplantation

Christophe Legendre, Richard Viebahn, Marta Crespo, Frank Dor, Bengt Gustafsson, Undine Samuel, Vincent Karam, Isabelle Binet, Fredrik Aberg, Sabina De Geest, Dirk Jan A. R. Moes, Burkhard Tonshoff (+5 others)
2019 Transplantation  
Tailoring Immunosuppression Therapy TDM is an important tool to optimize therapy with immunosuppressive drugs that have a narrow therapeutic window, poor correlation between dosage and blood concentration  ...  The European Network for Collaboration on Kidney Exchange Programmes is a program supported by COST to develop strategies to implement a collaborative KEP to allow organs to be exchanged between countries  ... 
doi:10.1097/tp.0000000000002846 pmid:31449167 fatcat:zpxvpuq2qregdm3x3lfwquxixa

KDIGO Guidelines for Care of the Kidney Transplant Recipient

A. Khwaja
2010 Nephron Clinical Practice  
Clinical practice guidelines from Kidney Disease Improving Global Outcomes (KDIGO) relating to the care of the kidney transplant patient were published in 2009 [1] .  ...  comprehensive guidelines also identify key areas of future research highlighting the need for randomised controlled trials to determine the value of steroid avoidance, the utility of protocol biopsies, the optimal  ... 
doi:10.1159/000314547 pmid:20460937 fatcat:oqayhnxgzrezxjv3cuqu4ryt6e

Three year results of the pioneer ABOi renal transplant program in Malaysia

S.Y. Tan, M. Rao, E.T. Koh
2016 Transplantation Reports  
Our low complication rates of rejection and infection suggest that the desensitization and maintenance immunosuppression protocol we utilized provided the optimal balance between maximizing immunosuppression  ...  The use of ABO incompatible donors may effectively increase organ donor pools especially in Malaysia where both cadaver and living related kidney transplant rates remain poor with sub-optimal outcome.  ... 
doi:10.1016/j.tpr.2016.04.001 fatcat:uzwhzh2b2rh2dgasmxp3yodh7u
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